Physician burnout and professional satisfaction in orthopedic surgeons during the COVID-19 Pandemic

BACKGROUND: Burnout and professional satisfaction is an often an overlooked component for healthcare outcomes; the COVID-19 pandemic represents an unprecedented stressor that could contribute to higher levels of burnout. OBJECTIVES: Our primary objective was to evaluate the association of a battery of fulfillment, job satisfaction change, COVID-19 concerns, and coping measures. Our secondary objective was to determine whether the fulfillment and coping measures differed by gender and by experience levels among a battery of physician specialties. METHODS: The study was a purposive sample of convenience. Study participants included all trainees and attending orthopedic surgeons from our academic institution; all participants were invited to complete a survey built around a validated measure of professional fulfillment aimed at assessing response to acute change and stressors. We performed univariate statistics and a matrix correlational analysis to correlate different survey domains with variables of interest. RESULTS: The survey was sent electronically to 138 individuals; 63 surveys were completed (response rate = 45.7%). Twenty-seven (42.8%) individuals met the threshold criteria for fulfillment whereas 10 (15.9%) met the threshold for burnout. We found that surgeon perspectives on COVID-19 were not associated with burnout or professional fulfillment. Burnout was inversely associated with professional fulfillment (R = –0.35). Support seeking was noted to be correlated with professional fulfillment (R = 0.37). CONCLUSIONS: Stressors related to COVID-19 pandemic were not correlated with physician burnout and fulfillment. This held true even when stratifying by gender and by attending vs. trainee. Continued efforts should be implemented to protect against physician burnout and ensure professional fulfillment for Orthopedic surgeons.

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Clinical Equipoise and Treatment Decisions in Cervical Spondylotic Myelopathy

Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques ◽

10.1017/s0317167100005771 ◽

2007 ◽

Vol 34 (1) ◽

pp. 47-52 ◽

Cited By ~ 8

Author(s):

Michael Benatar

Keyword(s):

Cervical Spondylotic Myelopathy ◽

Controlled Trial ◽

Treatment Decisions ◽

Clinical Findings ◽

Primary Objective ◽

Cervical Cord ◽

Clinical Equipoise ◽

Cross Sectional ◽

Orthopedic Surgeons ◽

Secondary Objective

Objective:The primary objective of this study is to evaluate clinician attitudes towards the treatment of cervical spondylotic myelopathy (CSM) in order to determine whether clinical equipoise exists for a segment of this patient population. The secondary objective is to examine the factors that influence treatment decisions.Methods:Cross-sectional internet-based survey of neurologists, neurosurgeons and orthopedic surgeons.Results:Between 40-60% of respondents recommended surgery for (1) patients with minimal or no symptoms, but incidentally discovered increased T2 signal within the cervical cord on MRI, (2) patients with mild symptoms and indentation of the cervical cord but without increased T2 signal and (3) those with at least moderately severe clinical findings accompanied by MRI showing effacement of the thecal sac but without indentation of the cord or increased T2 signal. The severity of the radiological abnormalities most strongly influence treatment decisions.Conclusion:We conclude that clinical equipoise does exist for certain groups of patients with CSM, suggesting that a randomized controlled trial could be performed in this population.

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The Student Room Survey: Changes in the Post Graduate Study for Cardiothoracic Surgery

Journal of Surgical Sciences ◽

10.3329/jss.v23i2.46113 ◽

2020 ◽

Vol 23 (2) ◽

pp. 71-74

Author(s):

Md Faizus Sazzad ◽

Mohammed Moniruzzaman ◽

Dewan Iftakher Raza Choudhury ◽

Arif Ahmed Mohiuddin ◽

Raafi Rahman ◽

...

Keyword(s):

Thoracic Surgery ◽

Retrospective Analysis ◽

Primary Objective ◽

Graduate Study ◽

Postgraduate Students ◽

Depth Interview ◽

Secondary Objective ◽

Cardio Vascular ◽

The University ◽

Day By Day

Background: The number of postgraduate students in Cardiac surgical discipline is increasing day by day with incremental proportion are measurably suffering from the unnecessary lingering of the present course curriculum. The primary objective of this study was to find out the last 5 years’ of results of Masters in Surgery course under the University of Dhaka from a student room survey. A secondary objective was to find out positive changes that could show us the way of a step toward up-gradation. Methods: It is a retrospective analysis of all examination results of Cardio-vascular & Thoracic Surgery published since January 2008 to January 2013 from the University of Dhaka with in depth interview of 11 participants. Results: 85.24% students failed to pass part-I of Masters in Surgery for Cardio-vascular & Thoracic Surgery course while, 82.18% in part-II and 71.28% failed to pass the final part. Average 2.51 attempts needed to complete each part of the designed course resulted into lingering of course duration for 42.18 months/student. In the thoracic surgery discipline the number of students alarmingly reduced up to 0% in the recent academic sessions. Conclusions: Masters in Surgery is resulting in unnecessary prolongation of the course. We should step forward to meet the next generation challenge. Journal of Surgical Sciences (2019) Vol. 23(2): 71-74

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Epidemiology of pheochromocytoma and paraganglioma: population-based cohort study

Acta Endocrinologica ◽

10.1530/eje-20-0628 ◽

2021 ◽

Vol 184 (1) ◽

pp. 19-28

Author(s):

Alexander A Leung ◽

Janice L Pasieka ◽

Martin D Hyrcza ◽

Danièle Pacaud ◽

Yuan Dong ◽

...

Keyword(s):

Cohort Study ◽

Administrative Data ◽

Laboratory Data ◽

Population Based ◽

Incidence Rates ◽

Primary Objective ◽

Administrative Databases ◽

Secondary Objective ◽

True Frequency ◽

Clinical Records

Objective Despite the significant morbidity and mortality associated with pheochromocytoma and paraganglioma, little is known about their epidemiology. The primary objective was to determine the incidence of pheochromocytoma and paraganglioma in an ethnically diverse population. A secondary objective was to develop and validate algorithms for case detection using laboratory and administrative data. Design Population-based cohort study in Alberta, Canada from 2012 to 2019. Methods Patients with pheochromocytoma or paraganglioma were identified using linked administrative databases and clinical records. Annual incidence rates per 100 000 people were calculated and stratified according to age and sex. Algorithms to identify pheochromocytoma and paraganglioma, based on laboratory and administrative data, were evaluated. Results A total of 239 patients with pheochromocytoma or paraganglioma (collectively with 251 tumors) were identified from a population of 5 196 368 people over a period of 7 years. The overall incidence of pheochromocytoma or paraganglioma was 0.66 cases per 100 000 people per year. The frequency of pheochromocytoma and paraganglioma increased with age and was highest in individuals aged 60–79 years (8.85 and 14.68 cases per 100 000 people per year for males and females, respectively). An algorithm based on laboratory data (metanephrine >two-fold or normetanephrine >three-fold higher than the upper limit of normal) closely approximated the true frequency of pheochromocytoma and paraganglioma with an estimated incidence of 0.54 cases per 100 000 people per year. Conslusion The incidence of pheochromocytoma and paraganglioma in an unselected population of western Canada was unexpectedly higher than rates reported from other areas of the world.

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Incidência da utilização de protetores bucais em diversos esportes de contato

Full Dentistry in Science ◽

10.24077/2020;1245-118122 ◽

2020 ◽

Vol 12 (45) ◽

pp. 118-122

Author(s):

Victor Paes Dias Gonçalves ◽

Hugo Leonardo Matias Nahmias ◽

Marcus Menezes Alves Azevedo

Keyword(s):

Martial Arts ◽

Rio De Janeiro ◽

Dental Trauma ◽

Primary Objective ◽

Type Ii ◽

Contact Sports ◽

The Face ◽

Secondary Objective ◽

The City

Among contact sports, the practice of martial arts offers a greater risk of causing dental trauma and fractures as contact with the face is more frequent. The primary objective of the research is to evaluate the incidence of mouthguard use, and the secondary objective is to verify which type has a greater predominance and the difficulties in its use correlating to the type of mouthguard used. A documentary study was carried out with 273 athletes of different contact sports, among them: MMA, Boxing, Muay Thai, Jiu-Jitsu, and Taekwondo of the city of Campos dos Goytacazes, Rio de Janeiro, Brazil. It was concluded that the most commonly used mouthguard is PB Boils and Bites - Type II and its level of approval is poor, interfering with the athletes’ performance, mainly in relation to the breathing factor.

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Use of Ceftaroline in Hospitalized Patients with and without COVID-19: A Descriptive Cross-Sectional Study

Antibiotics ◽

10.3390/antibiotics10070763 ◽

2021 ◽

Vol 10 (7) ◽

pp. 763

Author(s):

Daniele Roberto Giacobbe ◽

Chiara Russo ◽

Veronica Martini ◽

Silvia Dettori ◽

Federica Briano ◽

...

Keyword(s):

Bacterial Infections ◽

Bloodstream Infections ◽

Cross Sectional Study ◽

Primary Objective ◽

Sectional Study ◽

Cross Sectional ◽

First Line Therapy ◽

Large Teaching Hospital ◽

Secondary Objective ◽

Medical Wards

A single-center cross-sectional study was conducted to describe the use of ceftaroline in a large teaching hospital in Northern Italy, during a period also including the first months of the coronavirus disease 2019 (COVID-19) pandemic. The primary objective was to describe the use of ceftaroline in terms of indications and characteristics of patients. A secondary objective was to describe the rate of favorable clinical response in patients with bloodstream infections (BSI) due to methicillin-resistant Staphylococcus aureus (MRSA-BSI) receiving ceftaroline. Overall, 200 patients were included in the study. Most of them had COVID-19 (83%, 165/200) and were hospitalized in medical wards (78%, 155/200). Included patients with COVID-19 pneumonia were given empirical ceftaroline in the suspicion of bacterial co-infection or superinfection. Among patients with MRSA-BSI, ceftaroline was used as a first-line therapy and salvage therapy in 25% (3/12) and 75% (9/12) of cases, respectively, and as a monotherapy or in combination with daptomycin in 58% (7/12) and 42% (5/12) of patients, respectively. A favorable response was registered in 67% (8/12) of patients. Improving etiological diagnosis of bacterial infections is essential to optimize the use of ceftaroline in COVID-19 patients. The use of ceftaroline for MRSA-BSI, either as a monotherapy or in combination with other anti-MRSA agents, showed promising rates of favorable response.

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Multicenter point prevalence evaluation of the utilization and safety of drug therapies for COVID-19 at the onset of the pandemic timeline in the United States

American Journal of Health-System Pharmacy ◽

10.1093/ajhp/zxaa426 ◽

2021 ◽

Author(s):

Nathaniel J Rhodes ◽

Atheer Dairem ◽

William J Moore ◽

Anooj Shah ◽

Michael J Postelnick ◽

...

Keyword(s):

Clinical Trials ◽

Drug Therapy ◽

Supportive Care ◽

The United States ◽

Primary Objective ◽

Point Prevalence ◽

Medical Centers ◽

Academic Medical ◽

History Of ◽

Secondary Objective

Abstract Disclaimer In an effort to expedite the publication of articles related to the COVID-19 pandemic, AJHP is posting these manuscripts online as soon as possible after acceptance. Accepted manuscripts have been peer-reviewed and copyedited, but are posted online before technical formatting and author proofing. These manuscripts are not the final version of record and will be replaced with the final article (formatted per AJHP style and proofed by the authors) at a later time. Purpose There are currently no FDA-approved medications for the treatment of coronavirus disease 2019 (COVID-19). At the onset of the pandemic, off-label medication use was supported by limited or no clinical data. We sought to characterize experimental COVID-19 therapies and identify safety signals during this period. Methods We conducted a non-interventional, multicenter, point prevalence study of patients hospitalized with suspected/confirmed COVID-19. Clinical and treatment characteristics within a 24-hour window were evaluated in a random sample of up to 30 patients per site. The primary objective was to describe COVID-19–targeted therapies. The secondary objective was to describe adverse drug reactions (ADRs). Results A total of 352 patients treated for COVID-19 at 15 US hospitals From April 18 to May 8, 2020, were included in the study. Most patients were treated at academic medical centers (53.4%) or community hospitals (42.6%). Sixty-seven patients (19%) were receiving drug therapy in addition to supportive care. Drug therapies used included hydroxychloroquine (69%), remdesivir (10%), and interleukin-6 antagonists (9%). Five patients (7.5%) were receiving combination therapy. The rate of use of COVID-19–directed drug therapy was higher in patients with vs patients without a history of asthma (14.9% vs 7%, P = 0.037) and in patients enrolled in clinical trials (26.9% vs 3.2%, P < 0.001). Among those receiving drug therapy, 8 patients (12%) experienced an ADR, and ADRs were recognized at a higher rate in patients enrolled in clinical trials (62.5% vs 22%; odds ratio, 5.9; P = 0.028). Conclusion While we observed high rates of supportive care for patients with COVID-19, we also found that ADRs were common among patients receiving drug therapy, including those enrolled in clinical trials. Comprehensive systems are needed to identify and mitigate ADRs associated with experimental COVID-19 treatments.

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Reducing Loneliness: The Impact of Mindfulness, Social Cognitions, and Coping

Psychological Reports ◽

10.1177/0033294121997779 ◽

2021 ◽

pp. 003329412199777

Author(s):

Robin Besse ◽

Whitney K. Whitaker ◽

Laura A. Brannon

Keyword(s):

Young Adults ◽

Social Cognitions ◽

Age Group ◽

Coping Behaviors ◽

Current Health ◽

Current State ◽

And Coping ◽

Study Participants ◽

The Impact ◽

At Home

While many facets of loneliness have been explored, research examining the efficacy of loneliness interventions has been overlooked among young adults. The study of loneliness among young adults has become increasingly important considering the current state of isolation and stay-at-home orders issued to prevent the spread of COVID-19. Preliminary reports suggest an increase in loneliness as a result of the current health pandemic, especially among young adults, who have reported feeling lonelier than any other age group. Such findings warrant the study of ways to help reduce loneliness among young adults. The current study examined the efficacy of strategies that might be used to help young adults manage feelings of loneliness. Two hundred and seventy-eight young adults completed the study. Participants read one of four messages: mindfulness, social cognitions, coping behaviors, or a control. Participants in the mindfulness condition felt better equipped to manage future instances of loneliness and held better attitudes toward this intervention. The current research helps to advance understanding of effective ways of helping young adults cope with loneliness.

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Domestic violence and coping strategies among married adults during lockdown due to Coronavirus disease (COVID-19) pandemic in India: a cross-sectional study

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2021.59 ◽

2021 ◽

pp. 1-29

Author(s):

Priyanka Sharma ◽

Anita Khokhar

Keyword(s):

Domestic Violence ◽

Coping Strategies ◽

Descriptive Analysis ◽

Cross Sectional Study ◽

Systematic Research ◽

Sectional Study ◽

Cross Sectional ◽

Frontline Workers ◽

And Coping ◽

Study Participants

Abstract Background: There has been a reported increase in cases of domestic violence during the coronavirus disease (COVID-19) pandemic, however systematic research data is still unavailable. This study was conducted to find out domestic violence prevalence and coping strategies among married adults during lockdown due to COVID-19 in India. Methodology: A cross-sectional study was conducted among married men and women in the month of April 2020. Data regarding socio-demographic profile, domestic violence and coping strategies employed during lockdown was collected thorough google forms. 97.9% forms were completely filled by the respondents. Descriptive analysis was done. Results: Out of 94 study participants, about 7.4% (n=7) had faced domestic violence during lockdown. Out of these 7 participants, about 85.7% (n=6) reported increased frequency of domestic violence during lockdown. About half of the victims chose to ignore it (57.1%, n=4) or used yoga/meditation (42.9%, n=3) to cope. Conclusion: With about 7.4% study participants facing domestic violence during lockdown, it is necessary to study its detailed epidemiology in pandemics so that interventions like helpline numbers, screening of patients during tele-consultation, etc. which can be delivered even during lockdown with the help of healthcare and frontline workers could be devised to address this problem.

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Identification and Characterization of Unique Subgroups of Chronic Pain Individuals with Dispositional Personality Traits

Pain Research and Management ◽

10.1155/2016/5187631 ◽

2016 ◽

Vol 2016 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

S. Mehta ◽

D. Rice ◽

A. McIntyre ◽

H. Getty ◽

M. Speechley ◽

...

Keyword(s):

Chronic Pain ◽

Personality Traits ◽

Clinical Outcomes ◽

High Risk Group ◽

Comprehensive Treatment ◽

Cluster Membership ◽

Significant Difference ◽

Secondary Objective ◽

The Difference ◽

And Coping

Objective.The current study attempted to identify and characterize distinct CP subgroups based on their level of dispositional personality traits. The secondary objective was to compare the difference among the subgroups in mood, coping, and disability.Methods.Individuals with chronic pain were assessed for demographic, psychosocial, and personality measures. A two-step cluster analysis was conducted in order to identify distinct subgroups of patients based on their level of personality traits. Differences in clinical outcomes were compared using the multivariate analysis of variance based on cluster membership.Results.In 229 participants, three clusters were formed. No significant difference was seen among the clusters on patient demographic factors including age, sex, relationship status, duration of pain, and pain intensity. Those with high levels of dispositional personality traits had greater levels of mood impairment compared to the other two groups (p<0.05). Significant difference in disability was seen between the subgroups.Conclusions.The study identified a high risk group of CP individuals whose level of personality traits significantly correlated with impaired mood and coping. Use of pharmacological treatment alone may not be successful in improving clinical outcomes among these individuals. Instead, a more comprehensive treatment involving psychological treatments may be important in managing the personality traits that interfere with recovery.

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A Pilot Study Assessing Type a Behavior in Violence-Prone Inmates

Psychological Reports ◽

10.2466/pr0.1986.59.2.371 ◽

1986 ◽

Vol 59 (2) ◽

pp. 371-382 ◽

Cited By ~ 3

Author(s):

Bernadette H. Schell ◽

Jean-Charles Cachon ◽

Ozhand Ganjavi ◽

Frank Porporino

Keyword(s):

Multivariate Analysis ◽

Type A ◽

Type A Behavior ◽

Primary Objective ◽

Prison Inmates ◽

Activity Profile ◽

Voice Analysis ◽

Assessment Techniques ◽

Secondary Objective ◽

Violent Offenses

This study compared the Type A tendencies reported on the Behavior Activity Profile questionnaire and those yielded by a taped-voice analysis of 34 male prison inmates convicted for a variety of violent offenses. The primary objective was to provide prison officials with an instrument for detecting repeated assaulters from nonassaulters. The secondary objective was to determine which of the two Type A assessment techniques was more predictive of prisoners' status as assaulters. The multivariate analysis indicated that the profile, prisoners' length of sentence, and number of convictions accounted for 88% of the variance in grouping, assaulter or nonassaulter. Implications for prison administrators and researchers were discussed.

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